| NPI | 1710518139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 10002906A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002906A) |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-08-28 |